NPI | 1215623921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: SC 25093) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: SC 25093) |
Enumeration Date | 2023-04-14 |
Last Update Date | 2023-04-14 |